This
recent story from
Bloomberg got me somewhat irritated today. The story discusses how medical
school students are burdened with medical school debt. Going to a private
medical school for 2012-2013 is over $50,000 according to
the AAMC. What is really shocking is that 79% of medical school students will
have more than $100,000 in debt. Note this is just for going to medical school
this doesn’t even begin to look at overall debt (mortgage, car payments, credit
card debt, etc).
I
examined the 2012 physician compensation report (by Medscape) which can be
found here.
Salaries range on the low end of $156,000 for pediatrics to $315,000 for
radiology. Specialties like gastroenterology can make over $300,000 while
plastic surgeons make $270,000 and internal medicine doctors make $165,000.
What I found it interesting that 9% of doctors don’t discuss the cost of
treatments considering they don’t even know what the costs are. In the business
world you would be out of business if you had no idea what the costs were.
The
question is why is medical school become so expensive? Medical knowledge has
only grown exponentially over time and you could argue doctors know actually
face competition because patients can often Google their symptoms and figure
out what they have (doctors also use Google as well). This surgeon discusses what
practicing surgery was like in the 1970’s.
Supercomputer
Watson (made by IBM) can analyzed 1.5 million records in seconds, attend
medical school under a minute, in just two years researchers at the for-profit
IBM have reduced the size of Watson from a master bedroom to a pizza box while
increasing the speed by 240%. Conventional medicine can get diagnoses right
only 50% of the time while Watson can get around 90% of cases correct (less for
cancer given how complex they are). Of course, these percentages will only
improve over time.
What
is interesting is that the average MCAT and GPA scores of the people who get
accepted into medical school has steadily risen since
2001. According to this medical journal from 1911 there were
129 medical schools which is roughly the same number of medical schools in
2013! Granted since 1911 the population has exponentially grown exponentially
so by definition there are fewer people per doctors. This may be why so
many doctors don’t spend much time with patients.
A
no-brainer would be to allow more medical schools to open to allow let more
people become physicians. Starting a medical school is no easy task either.
Another no brainer is allowing nurse
practitioners
and physicians assistants as I mentioned in this
post. The
empirical evidence I have seen shows nurse practitioners and physician
assistants as just as effective as doctors and cost a fraction of what doctors
cost. The cost of medical education falls is yet another example of the
Peter Rule. The Peter Rule which states that: over time if prices rise and
qualify suffers look to government intervention as the culprit.
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